While stroke is the third leading cause of death in the United States, it is the leading cause of long-term disability in the American population. In the last decade, the majority of research efforts were directed toward treatment of acute stroke: re-establishing perfusion of the affected areas and minimizing neuronal damage. With the advance of acute stroke treatment, the issues of functional restoration and post-stroke rehabilitation have become increasingly important. Post-stroke rehabilitation is a significant component of stroke treatment in the clinic. Nonetheless, most rehabilitation practices are empirical and rely on behavioral approaches.
Recent advances in studies of post-stroke brain repair have revealed the complexity of the processes initiated by this kind of lesions in the brain. These processes include molecular, cellular, and systems mechanisms that take place in peri-lesional, as well as remote brain areas (Kreisel et al 2006 Cerebrovascular disorder).
It is well-established that stroke increases neurogenesis. Neural stem cells originating in subventricular and subgranular zones begin to migrate to the injury site after stroke, where they are able to mature into newly-generated neurons (Kalluri and Demsey 2008, Neurosurg Focus, Kadam et al 2008 Brain Res). Thus, the brain has some mechanisms of self-repair. However, there remains a need to enhance the brain recovery mechanisms leading to an improved functional recovery after stroke.